Guns, Suicide, and Mental Illness: A Roundtable Discussion

Recently, our country got a wake-up call. The Centers for Disease Control and Prevention (CDC) released new data showing that from 1999 through 2017, the national suicide rate increased 33 percent. This increase, which is consistent across all demographics, puts the suicide death rate at its highest level in at least 50 years. Additionally, over the last 10 years, the age-adjusted firearm suicide rate increased 19 percent.

Coalition to Stop Gun Violence Policy Analyst Dakota Jablon, Executive Editor Bryan Barks, and Director of Public Health Programs Vicka Chaplin came together to share thoughts on firearm suicide, mental illness, and laws that can save lives. Their conversation is below.

What drives your passion for suicide prevention?

Dakota Jablon (DJ): Suicide is a leading cause of death in this country — yet I often feel like no one talks about it. It’s a very misunderstood and stigma-ridden topic. As a suicide attempt survivor myself, I’ve long felt this deep shame and stigma. It was just last year that I openly admitted to my past suicidality. People are often shocked when I tell them, because I don’t fit the “mold” of someone who they think would be suicidal. I think that’s why it’s so important to share my story and be an advocate — to give a face in a way to what suicide prevention is.

Bryan Barks (BB): I have bipolar disorder, and suicidality is a symptom I’ve struggled with for much of my adult life. Trying to manage suicidality is so difficult and so lonely, and it’s made worse by the fact that we don’t talk openly about suicide as a society. Stories of hope and survival and resilience often go untold because the stigma surrounding suicide is so strong. People feel they are alone in their struggles when they absolutely are not. So I’m passionate about breaking down that harmful silence and spreading the message that suicide is preventable.

Vicka Chaplin (VC): Imagine what the world, communities, families, and individuals gain when a suicide is prevented, and the heartbreak that is averted. That’s why I’m passionate about suicide prevention.

What is the relationship between firearms and suicide?

DJ: Firearms are one the most lethal suicide attempt methods. Half of all suicide deaths are completed by firearm. We also know access to a firearm in the home increases a person’s risk for suicide more than three-fold.

BB: About nine out of ten firearm suicide attempts result in death. Those who attempt suicide using a firearm rarely get a second chance. When guns are easily available, there is no time to reconsider. There is no time to let the acutely painful moment pass. Firearms make suicide too easy.

VC: Firearms make suicide attempts more lethal than other methods. When firearms are more readily available, people choose them more often for suicide attempts — and more frequently die as a result. When firearms are not available, even when people choose other methods to attempt suicide with, they much more often survive their attempts and most do not subsequently die by suicide.

New CDC data shows that firearm suicides are on the rise. What does this spike tell us? How can we reverse this trend?

DJ: Firearm suicide, and suicide in general, is on an upward trajectory. I think, unfortunately, we are just not doing enough suicide prevention work at the population level. By passing strong gun violence prevention laws that research has shown reduce suicide, we can reverse the firearm suicide trend and overall suicide trend.

BB: The first step in reversing this trend is acknowledging that access to firearms is indeed a risk factor for suicide. Once we are able to recognize this, we can take steps — including legislative steps — to put time and space between those at risk of suicide and firearms.

VC: Many factors contribute to large-scale trends like a rising suicide rate, but one factor may be related to firearm availability. We can reverse the trend by improving and instituting gun safety laws such as extreme risk laws, training healthcare providers to talk with their patients about guns, and encouraging gun owners to safely store their guns and talk to fellow gun owners about firearms and suicide prevention, such as via gun shop projects.

What is an extreme risk law? How can these laws prevent firearm suicide?

DJ: Extreme risk laws allow law enforcement and family members to petition a court to temporarily remove guns from individuals demonstrating behavioral risk factors for dangerousness. Research from Duke University found that Connecticut’s law, one of the first extreme risk laws in the country, has been an effective suicide prevention law. They found that for every 10–20 gun removals issued, one suicide was prevented.

BB: Extreme risk laws are unique because they allow those closest to an individual to take action when they recognize risk factors for dangerousness. These laws are based on behavior rather than diagnosis, so they avoid further stigmatizing people with mental illness.

VC: Extreme risk laws create time and distance between the at-risk individual and a gun. For someone who is suicidal, an extreme risk order allows for safer circumstances during which the individual may seek help and address the underlying causes of their suicidality. These orders provide due process for the respondent and a process to get their guns back after they are no longer at elevated risk.

Are there other laws that can prevent firearm suicide?

DJ: There are indeed! Mandatory waiting periods for firearm purchases, child access prevention laws, and permit-to-purchase laws have all been shown to reduce the firearm suicide rate.

BB: Voluntary self-prohibition laws would allow people who may have experienced suicidality in the past and recognize their own risk to put themselves on a no-buy list, preventing themselves from purchasing a gun. Voluntary self-prohibition gives agency to people who are at risk for suicide and allows them to prepare for potential moments of crisis when they are well enough to do so.

VC: Laws that reduce access to firearms, particularly by adding time and distance between firearms and high-risk individuals during high-risk periods, can prevent firearm suicides.

Is there a relationship between mental illness and gun violence? What about mental illness and suicide?

DJ: People with mental illness are actually more likely to be a victim of violent crime than the perpetrator. There is a correlation between mental illness and suicide; however, about half of the people who die by suicide did not have a diagnosed mental illness. This is why it’s so important to focus on behavior and not a diagnosis when discussing prevention policies.

BB: The vast majority of those with mental illness will never be violent. Mental illness is often used as a scapegoat when acts of violence occur, but this is not based in evidence.

VC: Mental illness does not cause gun violence. Stereotypes that indicate otherwise are based on myth and stigma. Mental illness is a risk factor for suicide, but the majority of people with mental illnesses are not suicidal. Mental illness alone is not a good predictor of future violence, whether directed at others or oneself.

How can we change the way we talk about mental illness? Why is making this change important?

DJ: We can use non-stigmatizing language when talking about mental illness. For instance, not saying “dangerously mentally ill” or conflating “mental illness” with being crazy. It’s not only inaccurate, but it’s incredibly disparaging to the millions of Americans who live with mental illness.

BB: We need to stop equating mental illness with dangerousness or moral bankruptcy. I cringe when I encounter the term “dangerously mentally ill” or hear someone say “mentally ill” when they mean incomprehensible, illogical, inhumane, evil, or dangerous. When we call all people with mental illness “dangerous” or automatically blame mental illness for horrific acts of violence, we are pointing the finger at an entire demographic. We are perpetuating a damaging stereotype that hurts a huge, diverse community. It’s discriminatory.

VC: The way we talk influences the way we think about things, including mental health and illness. When people use stigmatizing language, it reinforces stigma and misperceptions, and can be hurtful to the people who experience mental illness. A simple change that anyone can do is to use person-first language, which helps to emphasize humanity and dignity rather than solely a diagnosis. For example, saying “people with mental illness” rather than “the mentally ill.” This recognizes that people with mental illness are just that: people with mental illness — and so much more.

What is one of the most common misconceptions you hear about suicide and/or mental illness?

DJ: One of the biggest myths I hear is that people who are suicidal will inevitably find a way to die — that suicide is not preventable. And we know that that’s just not the case. Nine out of 10 suicide attempt survivors are people like me, who do not go on to die by suicide.

BB: A lot of people don’t realize that they know someone who lives with mental illness. On numerous occasions, people have made disparaging comments about “the mentally ill” to me without realizing they are talking to someone with mental illness. Approximately 1 in 5 adults in the United States experiences mental illness in a given year. Once you recognize how many people live with these illnesses, you begin to realize how many people are forced to hide. And you begin to understand that calling this entire group of people “dangerous” is incorrect and counterproductive.

VC: I often hear criticism from people who say that suicide “doesn’t count” as gun violence. Many of those voices are critical of the gun violence prevention movement, but I think it is important for us to work on shifting those views so that we come to see the problem of gun violence more holistically — to include homicides, suicides, unintentional deaths, and non-fatal shootings, even threat with a gun. It’s all gun violence, and we should work to prevent all of it.

Five years from now, what do you hope the gun violence prevention movement will have accomplished with regards to suicide prevention?

DJ: I hope that suicide prevention is seen as important part of gun violence prevention, not only within the movement, but within the media and by our politicians. I also hope that the movement actively is advocating for gun violence prevention policies that we know will be prevent firearm suicides. I hope that the firearm suicide rate actually decreases, rather than continually increasing.

BB: The movement as a whole seems to be talking about firearm suicide more, and I hope that trend continues. I hope the movement continues to embrace evidence-based suicide prevention policies like extreme risk laws. And I hope we can do all of this while consciously avoiding stigmatizing language. If our movement is going to be truly inclusive, we need more people with mental illness at the table.

VC: Gun suicide is on the rise — we need to stop and reverse this trend with evidence-based policies. Our families and communities simply can’t afford not to.